<!DOCTYPE html>
<!--
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and open the template in the editor.
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<html>
    <head>
        <title></title>
        <meta charset="UTF-8">
        <meta name="viewport" content="width=device-width, initial-scale=1.0">
        <link rel="shortcut icon" href="favicon.ico"> <link href="__PUBLIC__/newWeb/css/bootstrap.min.css" rel="stylesheet">
        <link href="__PUBLIC__/newWeb/css/font-awesome.css" rel="stylesheet">
        <link href="__PUBLIC__/newWeb/css/animate.css" rel="stylesheet">
        <link href="__PUBLIC__/newWeb/css/style.css" rel="stylesheet">


        <script type="text/javascript" src="__PUBLIC__/city_selector/jquery.min.js"></script>
        <script type="text/javascript" src="__PUBLIC__/city_selector/data.js"></script>
        <script type="text/javascript" src="__PUBLIC__/city_selector/selector.js"></script>
        <script type='text/javascript'>
            //自定义配置
            var config = {
                province: '#province',
                city: '#city',
                area: '#area'
            };
            //初始化
            $(function () {
                selector(config);
            });
        </script>
    </head>
    <body class="gray-bg">
        <div class="row">
            <div class="wrapper-content animated fadeInRight">
                <div class="ibox-title">
                     <h5 style="padding-left: 5px">添加新医院</h5>
                </div>
                <div class="ibox-content">

                    <form class="form-horizontal m-t" id="commentForm" action="__ACTION__" method="post">
                        <div class="form-group">
                            <label class="col-sm-3 control-label">医院名称：</label>
                            <div class="col-sm-8">
                                <input name="name" type="text" class="form-control" required>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">省：</label>
                            <div class="col-sm-8">
                                <select id="province" name="province" required></select>
                            </div>
                        </div><div class="form-group">
                            <label class="col-sm-3 control-label">市：</label>
                            <div class="col-sm-8">
                                <select id="city" name="city" required></select>
                            </div>
                        </div><div class="form-group">
                            <label class="col-sm-3 control-label">区：</label>
                            <div class="col-sm-8">
                                <select id="area" name="area" required></select>
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">地址：</label>
                            <div class="col-sm-8">
                                <input type="text" class="form-control" name="address" required="" aria-required="true">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">固定电话：</label>
                            <div class="col-sm-8">
                                <input type="tel" class="form-control" name="telephone">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">移动电话：</label>
                            <div class="col-sm-8">
                                <input type="tel" class="form-control" name="phone">
                            </div>
                        </div>
                        <div class="form-group">
                            <label class="col-sm-3 control-label">备注：</label>
                            <div class="col-sm-8">
                                <textarea name="remark" class="form-control" required="" aria-required="true"></textarea>
                            </div>
                        </div>
                        <div class="form-group">
                            <div class="col-sm-4 col-sm-offset-3">
                                <button class="btn btn-primary" type="submit">添加</button>
                                <button class="btn btn-primary" type="button" onclick="back();">返回</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
        <!-- 全局js -->
        <script src="__PUBLIC__/newWeb/js/jquery.min.js"></script>
        <script src="__PUBLIC__/newWeb/js/bootstrap.min.js"></script>

        <!-- 自定义js -->
        <script src="__PUBLIC__/newWeb/js/content.js"></script>

        <!-- jQuery Validation plugin javascript-->
        <script src="__PUBLIC__/newWeb/js/plugins/validate/jquery.validate.min.js"></script>
        <script src="__PUBLIC__/newWeb/js/plugins/validate/messages_zh.min.js"></script>

        <script src="__PUBLIC__/newWeb/js/demo/form-validate-demo.js"></script>


    <!-- Page-Level Scripts -->
    <script>
        function back() {
            location.href = "{:U('Hospital/hospitalList')}";
        }
        $(document).ready(function () {

        });
    </script>
    </body>
    
</html>
